Effects of circuit training or a nutritional intervention on body mass index and other cardiometabolic outcomes in children and adolescents with overweight or obesity

Abstract

Objective We aimed to assess the effectiveness of the first 6 months of a 24 month multidisciplinary intervention program including circuit training and a balanced diet in children and adolescents with obesity. Methods A quasi-experimental intervention trial included 242 participants (age [mean±standard deviation]: 11.3±2.06 years, 97 girls) of at least 85th percentile of age- and sex-specific body mass index (BMI). Participants were grouped into three to receive usual care (usual care group), exercise intervention with circuit training (exercise group), or intensive nutritional and feedback intervention with a balanced diet (nutritional group). Primary outcome was BMI z-score, while secondary outcomes included body composition, cardiometabolic risk markers, nutrition, and physical fitness. Results Among the participants, 80.6% had a BMI ≥ the 97th percentile for age and sex. The BMI z-score of the overall completers decreased by about 0.080 after 6 months of intervention (p < 0.001). After the intervention, both exercise and nutritional groups had significantly lower BMI z-scores than the baseline data by about 0.14 and 0.075, respectively (p < 0.05). Significant group by time interaction effects were observed between exercise versus usual care group in BMI z-score (β, -0.11; 95% confidence interval (CI), -0.20 to -0.023) and adiponectin (β, 1.31; 95% CI, 1.08 to 1.58); and between nutritional versus usual care group in waist circumference (β, -3.47; 95% CI, -6.06 to -0.89). No statistically significant differences were observed in any of the other secondary outcomes assessed. Conclusion Multidisciplinary intervention including circuit training and a balanced diet for children and adolescents with obesity reduced the BMI z-score and improved cardiometabolic risk markers such as adiponectin and waist circumference.

Prediabetes in Adolescents: Prevalence, Management and Diabetes Prevention Strategies

“… 53 A recent trial published its results from the first 6 months of a 24-month multidisciplinary intervention approach that included a balanced diet and circuit training among 242 children and adolescents aged 6 to 17 years with obesity. 54 The preliminary data showed improvement in BMI z-score (−0.14) in the exercise group and reduction in adiponectin and waist circumference, however they could find a significant decrease in HOMA-IR. Interestingly they performed a sensitivity analysis based on puberty stage and found significant reduction in HOMA-IR when considering pubertal participants only.…”

“…Interestingly they performed a sensitivity analysis based on puberty stage and found significant reduction in HOMA-IR when considering pubertal participants only. 54 Also, a meta-analysis which included 24 studies that assessed the effects of physical activity on fasting insulin showed positive effects in improving fasting insulin as a marker of pediatric insulin resistance, with the greater effects seem among those with higher BMI z-scores. 55 Different training interventions such as resistance, aerobic and circuit training were used between studies, as well as non-traditional games to encourage an increase in levels of physical activity.…”

“…Interestingly they performed a sensitivity analysis based on puberty stage and found significant reduction in HOMA-IR when considering pubertal participants only. 54 …”

Additive Effects of Exercise or Nutrition Intervention in a 24-Month Multidisciplinary Treatment with a Booster Intervention for Children and Adolescents with Overweight or Obesity: The ICAAN Study

“…According to previous research, the effectiveness of adding an intensive exercise component to a lifestyle intervention for children and adolescents is high for reducing BMI in the short term [20,21]. The short-term effects of adding an exercise program were significant in the ICAAN study as well, as the exercise group was the most successful in decreasing zBMI after 6 months of intervention, according to a previous paper on the ICAAN study [22]. Contrary to our expectations, the long-term effects of adding an exercise component to a multidisciplinary lifestyle intervention were not significantly different from the other groups who experienced more gradual weight loss.…”

Changes in Plasma Choline and the Betaine-to-Choline Ratio in Response to 6-Month Lifestyle Intervention Are Associated with the Changes of Lipid Profiles and Intestinal Microbiota: The ICAAN Study

“…The longitudinal Intervention for Childhood and Adolescent Obesity via Activity and Nutrition (ICAAN) study is a 2-year quasi-experimental intervention trial (cris.nih.go.kr, KCT0002718) to test interventions that can prevent excessive weight gain and improve several health indices in obese children and adolescents, which was conducted from August 2016 to May 2019. The study design and the effectiveness of the first 6 months of this program have previously been described [13]. In brief, 242 overweight, obese, and severely obese individuals were recruited into the ICAAN study and then assigned to three treatment groups as follows: usual care for obesity, including counseling on diet, physical activity and behavioral modification (usual care group); exercise intervention (exercise group); intensive nutritional and feedback intervention (nutritional group) group.…”